Think it’s easy to get Social Security disability benefit? Think there are lots of cheaters drawing those benefits? You’re not alone. You’re not right; not at all, but you’re not alone in your mistaken opinions as Tom Margenau details.
Not easy. Not a lot of cheaters on T2. Much easier to get on SSI as a child. Some adult cheaters on SSI but not because they aren't disabled but because of lying about living arrangement.
We started asking potential clients what percentage of disability claims do they think are fraudsters. Sometimes, exceptionally high answers can be excused due to the impairments involved. Otherwise, it's a decent screening method.
@7:33
True, SSA automatically denies at initial as well as recon. Also, while the LTD providers are quite horrible, they pretty much automatically award for the first two years, and then deny once the own occupation standard changes to the any occupation denial (effectively, in SSA terms, many, many, ltd policies only require the 4th step for the first two years, then move on to the 5th step after two years).
@11:27 Your post provides massively incorrect info.
Most of my claims are approved at initial and recon. I screen thoroughly and document, document, document. AND, LTD is NOT "pretty much automatically approved for first two years" nor do "insurers follow the 5 steps". LTD and SSDI are lightyears apart in definitions, how they work, are approved, continued. Unless, perhaps, if you have your SSDI clients stress mental/nervous/subjective conditions...in which case LTD can have a bonanza between limiting to 2 years AND offsetting entitlement. #
11:27 here. Your claims are not representative of the average state agency worker. Quotation marks are meant to show you are quoting someone. Given I never said insurers follow the 5 steps, that makes me question your screening capabilities.
I did not claim LTD providers follow the five steps, I said they only require the 4th step for the first 2 years, and apply the 5th step after 2 years. As to mental/nervous/subjective conditions limiting to 2 years, it's irrelevant, because after 2 years, they will terminate benefits, and then go and settle it, regardless. There's also relatively consistent caselaw, saying such provisions are pretty unenforceable, given any non-mental/nervous/subjective condition, means benefits continue. As to offsetting entitlement, that's not relevant to claims procedure.
lol millions and millions disabled--dude, we're a country of like 350 million people and heavily skewed towards the old, not to mention all the backbreaking low wage work our permanent under class performs and dismal healthcare. It's a small single-digit percentage of the population, get a grip.
In some states it is difficult to get on. But once someone is on DIB they never leave. MED CDRs are a joke with an over 90% continuance rate. Work CDRs do catch people but all they do is immediately stop working; they go back on in their EPE or file an EXR.
It's hard to get on. Disabled people have a hard time getting medical attention to prove their disability. Some regulations, like the grid that says that people under 50 aren't disabled because they can do unskilled sedentary work (where is it?) further make it difficult to qualify for disability. Here recently, we're getting CDR's for people who have been unable to access health care, especially mental health care, due to the pandemic.
Not easy.
ReplyDeleteNot a lot of cheaters on T2.
Much easier to get on SSI as a child.
Some adult cheaters on SSI but not because they aren't disabled but because of lying about living arrangement.
The average person I continue on a CDR is far less disabled and younger than the average person I deny at an initial or recon level.
ReplyDeleteAlso, SSA does not automatically deny the first time out and let some through on appeal.
ReplyDeleteWe're not Blue Cross.
We started asking potential clients what percentage of disability claims do they think are fraudsters. Sometimes, exceptionally high answers can be excused due to the impairments involved. Otherwise, it's a decent screening method.
ReplyDelete@7:33
True, SSA automatically denies at initial as well as recon. Also, while the LTD providers are quite horrible, they pretty much automatically award for the first two years, and then deny once the own occupation standard changes to the any occupation denial (effectively, in SSA terms, many, many, ltd policies only require the 4th step for the first two years, then move on to the 5th step after two years).
@11:27 Your post provides massively incorrect info.
ReplyDeleteMost of my claims are approved at initial and recon. I screen thoroughly and document, document, document. AND, LTD is NOT "pretty much automatically approved for first two years" nor do "insurers follow the 5 steps". LTD and SSDI are lightyears apart in definitions, how they work, are approved, continued. Unless, perhaps, if you have your SSDI clients stress mental/nervous/subjective conditions...in which case LTD can have a bonanza between limiting to 2 years AND offsetting entitlement. #
@5:26
ReplyDelete11:27 here. Your claims are not representative of the average state agency worker. Quotation marks are meant to show you are quoting someone. Given I never said insurers follow the 5 steps, that makes me question your screening capabilities.
I did not claim LTD providers follow the five steps, I said they only require the 4th step for the first 2 years, and apply the 5th step after 2 years. As to mental/nervous/subjective conditions limiting to 2 years, it's irrelevant, because after 2 years, they will terminate benefits, and then go and settle it, regardless. There's also relatively consistent caselaw, saying such provisions are pretty unenforceable, given any non-mental/nervous/subjective condition, means benefits continue. As to offsetting entitlement, that's not relevant to claims procedure.
Cant be too hard, there are millions and millions on benefits. If it was hard there would be less. Somebody has to work to pay for all this.
ReplyDeletelol millions and millions disabled--dude, we're a country of like 350 million people and heavily skewed towards the old, not to mention all the backbreaking low wage work our permanent under class performs and dismal healthcare. It's a small single-digit percentage of the population, get a grip.
ReplyDeleteIn some states it is difficult to get on. But once someone is on DIB they never leave. MED CDRs are a joke with an over 90% continuance rate. Work CDRs do catch people but all they do is immediately stop working; they go back on in their EPE or file an EXR.
ReplyDeleteIt's hard to get on. Disabled people have a hard time getting medical attention to prove their disability. Some regulations, like the grid that says that people under 50 aren't disabled because they can do unskilled sedentary work (where is it?) further make it difficult to qualify for disability. Here recently, we're getting CDR's for people who have been unable to access health care, especially mental health care, due to the pandemic.
ReplyDelete